Blown away

All I could think about yesterday morning was how tired I was, how it wasn't fair that I had to go to sleep at 10pm while everyone stayed up partying in my backyard. How I had to cut the margaritas short and stick to beer, and how I had to get up at 5am and go do a donor. So all the way into the city on my drive I grumbled and complained to myself. I had visions of being an OB nurse, wouldn't it be nice to see new life instead of death? Maybe easier to do a 12 hour shift and come home with no meetings or calls or complaints. I thought about how the people I work with right now are sorely lacking in a lot of things (thats a whole nother post) and I wouldn't miss some of them. Hmmm maybe a starbucks girl, a bartender? Anyway I looked at it, I was in for a busy 24 hours and I was miserable about it... until.

Until I got to the hospital. I was introduced to this family and I did a complete 360, I was so moved, so awed by their courageousness, their generosity and their spirit in the light of such tragedy. Here I was feeling sorry for myself and this family had every reason to be angry at everyone, at god, at whomever for having their loved one taken from them so early and suddenly. She was so young, had a teenage daughter and wonderful husband, 6 brothers and sisters, a huge family. And not ONE of them was angry, everyone was smiling and excited that they were helping other people live on. At that point I knew that maybe this might be God's way of saying " your not quitting yet, your going to keep doing this job". Because after I met them, I think I could have worked 48 hrs non stop. In my 4 years at this job, I have yet to meet a family like this one, and they have left a lasting mark on me. I think they might have just given me the gas to go another 4 years doing this job.

Later as I stood in the room with all 25+ of them and told them where their loved one's organs would be going, I cried as I looked around at their faces, the smiles and the excitement was so obvious. I think I have cried off and on with most donors but never like this. I cried because their love and spirit filled that room and I was so overwhelmed by that love and hope that they had. I told them I had never been so honored to work my tail off for 18 hrs for anyone. In the end her lungs, kidneys, liver and pancreas saved 5 people and her family can't wait to meet them.

This famiy stayed with me long after I left last night, even when my pager went off at midnight and I drove again into the city trying hard not to fall asleep, and again at 5am. Not once did I grumble or complain, knowing that this was all part of the process, that I had forever made a difference in a families life by doing what I did. As hard as it seems sometimes, as much as I disagree with political issues in the workplace, the policies, the co-workers, the gossip, etc, I will always have what I love and do best.

Amnesia in a bottle

I was on call this weekend. It's left me exhasted to say simply. I spent all day today almost on the phone with conference calls and I am tired of thinking about death. Yes people are living because of that death, but I never see them, its a one way mirror for me and thats hard. A co-worker just called me, she's frustrated with management and physically and mentally exhasted. I listened the best I could, being sympathetic but trying to stay objective. Sometimes I see her side, sometimes I see their side. Right now, I dont want to see either side... I dont want to think about work, the politics, the donors or the recipients. At least not right now, maybe tomorrow. I've already taken my allotted dose of advil today, thrown in a couple mutivitamins, some macrobid with some tums on top of that...

Monday night after going for a hard run to try to get the picture of my donor's young wife crying at his bedside, her 2 year old child, out of my head, I drank too much, so much for the calories burned (but well worth it). Sometimes I need to just wash it away with alcohol, or attempt to anyways. No... I am not an alcoholic, I find outlets in plenty other healthy places as stated above. But, as I was explaining to the nurse in the ICU as we were both crying with the wife, "this is a 2 drink case", and I meant it. Sometimes I just have to indulge for the sake of amnesia.

Alcohol is the anesthesia by which we endure the operation of life.
George Bernard Shaw (1856 - 1950)

I am sitting here with my feet propped up, a warm fuzzy blanket spread on top of my legs and my laptop sitting on top of that. I have the fire place going strong and its getting increasingly harder to stay awake for an afternoon conference call that I am required to be on. I was awake until midnight last night, not in bed until 1ish due to the necessity of food which I had been without the prior 12 hours. My husband, bless him, made me a turkey burger, which I enhaled the minute I sat down after getting home last night. I sat eating and watching the "pursuit of happiness", never hating and loving a movie so much. But it became emotionally too much to watch after the day I had had, so after kissing my boys and standing at their bedside for a few minutes staring at them, I finally I collapsed into my warm bed, my feet and heart aching.

Yesterday afternoon, I watched a mother say goodbye to her son. I watched a sister say goodbye to her brother. I watched a father say goodbye to his closest friend. And a girlfriend say her goodbyes also. Sadly, I have watched a thousand goodbyes over the past years, but for some reason, the wall was hard to throw up yesterday. Maybe it was because I was tired, or hadn't done a case in awhile. Maybe it was because I have boys and it hit me closer than most cases. Or maybe it's God's way of saying "Hey, your still human after all!". I cried in the room with the family, and for their loss. I cried because the thought of possibly being that mother someday, was more that I could handle. Surviving your kids must be horrible and something I never want to experience. I dont think she or he intended it to be that way, so why did God? It's a question I often wonder about.

That morning, I was up at 5, stopped at Starbucks on the corner and tried not the bite the head off the counter girl when they didnt have the coffee I wanted. (Pre-coffee mood sux). I drove to a local trauma center and started my day, contemplating the calories burned by standing on your feet for 24 hours... :) My donor was 27, and a good looking guy. Can't really spill the details, but he wasn't supposed to be there, and it was a sudden, possibly unexpected loss for this family. I was told he was an athelete, and his lungs and heart proved that. They were both very strong and some of the highest PO2s on ABGs I have seen in a long time. They saved the life of another young man in his 20s and imagining that families excitement and relief, was what kept me going strong and even prompted me to tell the OR circulating nurse: "I have the best job in the world" as I pulled my warm blanket around me in the freezing OR, my stomach rumbling, my feet and knees cramping, my face breaking out because I haven't washed it in 20 hrs. Yep the best job, wouldn't trade it for the world. I love the docs I work with, my co workers and the families I help. I love the proudness that echos in my kids voices when they tell people what their mom does. I honestly dont think I could do anything else, I try to think about it and fail. I am destined to do this for the rest of my life, but you know what? That suits me just fine.

This morning the alarm came much too early. I drug myself out of bed to see to two hungry children pacing the floors. I quickly sprouted another pair of arms and at the same time I: made coffee, made a bowl of cereal, heated up a breakfast burrito, threw some laundry in the dryer, signed two agendas, chewed out my son for not listening in class, and listened to the morning conference call with my phone of mute and speaker from the counter in the kitchen. My kids are used to hearing words like "brain dead", "trauma", "IPD, SDH" and "withdrawing care". Its almost as common to them as Sponge Bob saying "I want a crabby pattie!". Are they traumatized from it? No. Unless you call yelling at the other kids in the neighborhood to wear their helmets or they will be ''organ donors''. I am thinking I dont mind being on call today, I have had some time off. Went camping with the family, have had to time to regroup myself, drank far too much etoh and ate too much bad food, but it felt good. My younger son and I went mountain bike riding about 5 miles, he hung tough the whole way and found it incredibly fun on the downhill path back until a bump came up and threw him face first into the dirt, making him bleed on his lip and elbow. But he was ok, he says to me "good thing I had my helmet on mom!" I am thinking, uh yeah... This job makes you paranoid, as I have said before...

I am about ready to head home from the city if things stay the way they are, knock, knock.

See how I feel?

My kids both went to a NYE all night party and had a blast. NY day morning as they stumbled in the front door, dark rings under their eyes, their feet barely leaving the ground... I laughed to myself... Time for some education! After I listened to the "Mom I'm so tired, mom let me go!" cries, I made them pause and evaluate for jsut a moment how they felt. I said "Now tell me how you feel right now." I got a variety of answers, and whining with it. I said to them "Now, right now how you feel, is how mom feels when she works all night and comes home from work." They both just looked at me and trudged off to the bedroom. It was a sort of mini revenge for me... :)
I never made it home last night. After I visited the hospital that paged me, I got another call from the county hosital. The patient I had see earlier in the evening was very unstable. The resident tells me that if we want to give the family any option for donation, I needed to hurry on over. So I finished up and drove a fast 10 min to the hosital. Funny thing was, he was more stable than earlier in the evening, but the family had made him a DNR. It was a tragic situation for the whole family, a member of them being responsible for the injury. So sad that now so many people will be affected.
I pulled mom and 3 siblings into a small conference room. I wanted to much to take this mothers pain away from her and hoped what I had to say would lessen it even just 1%. I would feel successful if it was even 1%. I told her he could save up to 8 lives. I watched her face light up, her eyes opened wider and she sat up straiter. I had given her some hope, I could see that, so I continued. They all agreed he would want that, but they wanted to wait for his dad to arrive.
Today he is going to save people, I slept and am now awake and another coordinator is there continuing the case. As tired as I am, I love doing this. Makes me have faith in the world, amazement that people still possess generosity for those they have never met at the worse possible time of their lives. I believe that a mom who gives her son to help others when she is greiving so is such a hero, more so than anyone who may be labeled that. He gift is so unselfish, so selfless, so not for personal glory. Even after 4 years it never fails to move me like this.

“To laugh often and much; to win the respect of intelligent people and the affection of children...to leave the world a better place...to know even one life has breathed easier because you have lived. This is to have succeeded.”

New Years Day

All is quiet on New Year's Day.
A world in white gets underway.
I want to be with you, be with you night and day.
Nothing changes on New Year's Day.On New Year's Day.

Except there is no world in white, just brown today with some red here and there. And all is not totally quiet, though its just been referals today. One thing is, things do change new years day, neuro assessments for one.
I traveled around the city this morning, my first stop a hospital 10 min away. This isn't a place we have done many donors at, actually 1 to be specific. But they keep trying to their credit. Now if they would just understand that if someone breathes on their own, their brain works. Its black and white. Dead, or not dead. You either breath or you dont. Simple right? No. Not even for educated individuals, nurses and doctors included to understand. Sometimes I wonder how these people get their medical degrees and pass their state boards. So the patient I see is a young girl. I listen outside the room as the neurologist talks to the mother. She is overbreathing the vent and flexes, I know she isn't brain dead. He comes out and the charge RN and pts nurse ask if he is going to do brain death testing... oh jeez. We both explain that if the pt is breathing, no testing, no point. Blank stares... ohhh jeez. I also spend 30 minutes in the break room educating another nurse to that fact because she was frustrated over another pt that couldn't donate because they weren't brain dead. I told her there are things we dont compromise on, and thats one of them. We dont declare pts brain dead when they are still breathing. Simple right? No... apparently not. Sigh sigh double sigh.
I leave and journey NW to the big hospitals who's nurses understand somewhat more, but sometimes not. Things are crazy all over, I see a wife crying over her husband who collapsed taking xmas decorations down, I see a mom by her son's bedside praying. He was beat up last night at a party...
I come home and look at my kids, my oldest is told about the young kid, drinking, at a party, a normal child, but somehow I hope by telling him these things he will be somewhat unnormal...I dont know. I hope and pray everyday I am not that mom, or wife for that matter. Collateral damage from this job happens every day to me.
I just ate at my parents, about ready to head home and I get a page. The lady has cancer and I feel bad because I am happy I dont have to go. I'm so horrible sometimes, lord bless the starving pigmys in new guinney. oh no, the same hospital just paged me back, I was lucky once, but usually not twice.

Return trip

I was on call last night, just third call but there was a donor in progress so that put me to run referals so that the next day's 1st call could go and do OR fresh in the morning. Just as my head hit the pillow, my boss called me. She needed me to go see on old man across the city in a hospital about 50 min away. I pulled my body out of bed, I was so tired, and threw on a sweatshirt and scrub bottoms and jumped in my car and prepared myself with my ipod for the long drive. Once I arrived, I did my business. The pt wasn't brain dead, we would just follow. I left and thought, looong drive home and when I am almost home, my boss calls me again. Same hospital is calling in another referal. I scream WHAT?! into the phone and exit the next exit. I'm told to turn around and go see him, the nurse says he is brain dead and absent reflexes... oh wow, another 40 min back. I drive back feeling dejavu in my return trip, get out of my car and paste a smile on my face as I walk back in the ICU. I was just here, they could have called me then but they didn't. I walk back in smiling and the charge RN notices and apologizes and says she is sorry, and thank you for still smiling. I shrug, its my job... I can't be mad. Its what I do and I know they are busy... I can forgive it once. So I sit down to look at the chart and talk to the nurse. So they pt is brain dead I say, she says yes. I go through all the reflexes with her. Cough? No. Gag? no Corneals? no. Is he breathing on his own? No. Flexing? No. I chart all this but something tells me to go see first hand. Usually I dont do this, as there are 10 family members in the room, two in wheel chairs and its just cruel to ask them to leave sometimes. But I needed to know for sure and something in her affect tells me to double check. Once family is gone, I head in with the nurse in tow. I start with corneals. Yes they are there. I sigh... ok next. He has a STRONG gag and cough and continues to cough after I suction. Ok. He postures when I suction. Big sigh... ok. He isn't brain dead and I educate the RN on the nuero assessment which I feel should be something she is capable of doing correctly in an ICU? Correct me if I am wrong here. I talk over the plan, leave a note and head back home, praying I will make it back to my bed. 3 hrs later after I am originally called, I am back asleep. Little do I know the same ICU calls in another referal! My boss tells them, forget it. We have had someone there twice already tongiht, someone will come by in the morning first thing. Thank god because I would've had to go postal on them, and no smile this time.